How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,754 · 10th to 90th $1,549 to $3,981
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,445.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,445.44 | $1,445.44 | $1,778.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,949.84 Median $2,754.23 Typical High $3,981.07 | Professional | None | $1,949.84 | $2,754.23 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,041.74 Typical High $3,890.45 | Professional | None | $1,548.82 | $2,041.74 | $3,890.45 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $5,754.40 | Facility | None | $1,445.44 | $1,737.80 | $5,754.40 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,737.80 | $1,995.26 | $2,398.83 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $3,548.13 | Professional | None | $1,445.44 | $1,819.70 | $3,548.13 |
11 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $724.44 Typical High $891.25 | Professional | 52 · Reduced service | $724.44 | $724.44 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $354.81 | Professional | 53 · Discontinued | $288.40 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $269.15 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $177.83 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $1,000.00 Typical High $2,137.96 | Professional | 51 · Multiple procedures | $870.96 | $1,000.00 | $2,137.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $398.11 Typical High $851.14 | Professional | 80 · Assistant surgeon | $354.81 | $398.11 | $851.14 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $281.84 Typical High $588.84 | Professional | 81 · Minimal assistant surgeon | $245.47 | $281.84 | $588.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $281.84 Typical High $588.84 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $281.84 | $588.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $281.84 Typical High $588.84 | Professional | AS · PA/NP assist | $245.47 | $281.84 | $588.84 |
Where North Carolina sits
The same service costs 11.6 times more in Maine than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
ME $24,998MD $2,147
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.